UCSF

INTRODUCTION: Faster time to ambulation (TTA) after video assisted thoracoscopic surgery (VATS) is associated with improved outcomes. We hypothesized that reduced urinary catheter duration leads to shorter TTA after VATS lobectomy. METHODS: We studied VATS lobectomy patients from 2014 through 2018. TTA of patients that did not have urinary catheters or whose catheters were removed at the end of the operation (reduced cath) was compared to TTA of those whose catheters were removed the day after surgery (long cath). RESULTS: Overall, 67 and 234 patients were included in the reduced cath and long cath groups, respectively. Median TTA was shorter in the reduced cath group compared to the long cath group (6.5 h Q1-Q3: 4.8-10.7 vs 11.0 h Q1-Q3: 6.8-18.3, p<0.01). Length of stay, urinary complications, and 30-day readmissions were not significantly different between groups. DISCUSSION: While it is possible to ambulate with a urinary catheter in place, the presence of such a catheter nevertheless presents an additional barrier to early mobilization among VATS lobectomy patients. Despite other efforts to promote early ambulation within our integrated health system, we have found that avoiding urinary catheter use or removing them immediately post-operatively is associated with shorter times to initial ambulation. Given the known benefits of early ambulation among VATS lobectomy patients, reduction or omission of urinary catheters may provide an additional tool for surgeons to promote early mobilization. CONCLUSIONS: Reduction of urinary catheter duration is associated with reduced TTA after VATS lobectomy.